Bottom Line:
Synchronous malignancy of squamous cell carcinoma and malignant lymphoma in the head and neck region is extremely rare.Endoscopic examination of respective organs revealed a submucosal tumour on the posterior wall of pharynx.Biopsy of the hypopharynx was taken and sent for histological examination, which revealed two different neoplasms.

ABSTRACTSynchronous malignancy of squamous cell carcinoma and malignant lymphoma in the head and neck region is extremely rare. Nasopharyngeal carcinoma is a nonlymphomatous, squamous cell carcinoma that occurs in the nasopharyngeal epithelium. Reported herein is a unique case of nasopharyngeal carcinoma occurring simultaneously with MALT-type lymphoma in an 83-year-old woman, who complained of deglutition dysfunction. Endoscopic examination of respective organs revealed a submucosal tumour on the posterior wall of pharynx. Biopsy of the hypopharynx was taken and sent for histological examination, which revealed two different neoplasms. Immunohistochemical and molecular analysis confirmed the diagnosis of nasopharyngeal carcinoma coexisting with a MALT-type lymphoma.

Mentions:
Close beside the above-mentioned carcinoma, a lymphomatous monomorphic population was observed consisting of small-to medium-sized lymphoid cells with pale cytoplasm and slightly irregular nuclei (Figures 5 and 6). The lymphoid cells were localized in the deeper submucosal tissue of hypopharyngeal wall, infiltrating the striated muscle cells (Figure 6). Mitotic figures were usually few. Immunohistochemical stains demonstrated CD20 and CD45RA positivity, a finding consistent with the presence of a B-cell lineage lymphoma (Figure 7). Tumour cells were negative for T-cell markers, such as CD45RO and CD3, although a few reactive T-cells were scattered among the lymphomatous population. Stains for CD5, CD10, BCL6, CD23, and Cyclin D1 were also negative. On PCR analysis a monoclonal IGH gene rearrangement was detected and neither t(14;18) nor t(11;18) translocations were found by FISH analysis.

Mentions:
Close beside the above-mentioned carcinoma, a lymphomatous monomorphic population was observed consisting of small-to medium-sized lymphoid cells with pale cytoplasm and slightly irregular nuclei (Figures 5 and 6). The lymphoid cells were localized in the deeper submucosal tissue of hypopharyngeal wall, infiltrating the striated muscle cells (Figure 6). Mitotic figures were usually few. Immunohistochemical stains demonstrated CD20 and CD45RA positivity, a finding consistent with the presence of a B-cell lineage lymphoma (Figure 7). Tumour cells were negative for T-cell markers, such as CD45RO and CD3, although a few reactive T-cells were scattered among the lymphomatous population. Stains for CD5, CD10, BCL6, CD23, and Cyclin D1 were also negative. On PCR analysis a monoclonal IGH gene rearrangement was detected and neither t(14;18) nor t(11;18) translocations were found by FISH analysis.

Bottom Line:
Synchronous malignancy of squamous cell carcinoma and malignant lymphoma in the head and neck region is extremely rare.Endoscopic examination of respective organs revealed a submucosal tumour on the posterior wall of pharynx.Biopsy of the hypopharynx was taken and sent for histological examination, which revealed two different neoplasms.

ABSTRACTSynchronous malignancy of squamous cell carcinoma and malignant lymphoma in the head and neck region is extremely rare. Nasopharyngeal carcinoma is a nonlymphomatous, squamous cell carcinoma that occurs in the nasopharyngeal epithelium. Reported herein is a unique case of nasopharyngeal carcinoma occurring simultaneously with MALT-type lymphoma in an 83-year-old woman, who complained of deglutition dysfunction. Endoscopic examination of respective organs revealed a submucosal tumour on the posterior wall of pharynx. Biopsy of the hypopharynx was taken and sent for histological examination, which revealed two different neoplasms. Immunohistochemical and molecular analysis confirmed the diagnosis of nasopharyngeal carcinoma coexisting with a MALT-type lymphoma.